What is Medicare

What Is Medicare?

The Medicare program is a federal health insurance program for people 65 years of age or older and certain disabled people. It is run by the Centers for Medicare and Medicaid Services (CMS), a division of the U.S. Department of Health and Human Services. Social Security Administration offices across the country take applications for Medicare and provide general information about the program. Independent insurance carriers throughout the United States administer the claims processing.

There are two parts of the Medicare Program. Hospital insurance is known as Part A and medical insurance is known as Part B.

Does Your Patient Have Medicare?

Your patient should have a Medicare card. This card will show the health insurance claim number (HIC#). The cards will also show if the patient has Medicare Part A, Medicare Part B, or both, and the effective date of coverage. Most Medicare beneficiaries receive Part A benefits at no cost; however, they must choose whether or not they want the Part B coverage for a monthly premium, which is deducted from their Social Security check.
To verify your patient’s enrollment in the Medicare program:
•Check the beneficiary’s Medicare card
•Call the Medicare Part B Provider IVR

Railroad Retirees and their spouses have Medicare coverage through the Palmetto Government Benefit Administrators. The health insurance claim number (HIC#) has an alpha prefix with a 7 or 9 digit number. The most common prefixes are MA, WA, and A.